MCLM

Welcome to Bajaj Allianz Family
Policy issuing office and Correspondence address for communication AURUNGABAD-Abc East,,3rd Floor,,Chilkathana Midc,,
by policyholder for claim, service request, notice, summons, etc. Aurangabad,Maharashtra,431210,INDIA
Insured Name Yogesh Kamalakar Deshmukh Policy number 12-8435-0000079326-00
Name: Mandar Chandrakant Lokhande

Address:
Line1: Plot no 149/1 flat no 5 kamakshi gharkul Samarth nagar
Line2:
City: AURANGABAD State: 27 - MAHARASHTRA
Post Code: 431001
Email ID: mandarlokhande@gmail.com
Mobile Number: 8830490396
Customer ID: 85364590
Dear Mandar Chandrakant Lokhande,
It is our privilege to welcome you to the Bajaj Allianz General Insurance family.
We thank you for choosing Bajaj Allianz for your Insurance needs. We are one of India's leading general insurance companies with iAAA
rating from ICRA for the last ten consecutive years indicating the company's high claims paying ability and fundamentally strong
position in the industry. Please be assured that you have made right choice by choosing us and we will stand by you in your hour of
need.
Please find enclosed the policy schedule. We wish to inform you that the policy issued is based on the information submitted in the
proposal form as well as the acceptance of the terms and conditions, and this will be verified at the time of filing of claim. Request you
to kindly go through the same once again and in case of any disagreement, discrepancy or clarifications – write to us at
bagichelp@bajajallianz.co.in within 15 days of the letter date.For policy wordings containing detailed terms, conditions and exclusions
of your insurance coverage follow below link
https://www.bajajallianz.com/download-documents/health-insurance/health-ensure/Health_EnSure_pw.pdf
Once again, we welcome you to the Bajaj Allianz family and look forward to a long association with you.
We assure you the best of our services and look forward to a continual patronage and association with you.
For & on the behalf

Bajaj Allianz General Insurance Company Ltd.
Signature Not Verified

Digitally signed by DS BAJAJ
ALLIANZ GENERAL INSURANCE
COMPANY LIMITED 01
Date: 2023.11.29 12:36:19
0 IST
Authorized Signatory
Bajaj Allianz General Insurance Co. Bajaj Allianz House,Airport Road,Yerwada,Pune - 411 006. Reg. No.: 113 CIN: U66010PN2000PLC015329
Give a Missed Call on 808094506 SMS 'WORRY' to 575758 http://www.facebook.com/BajajAllianz
Contact our 24-Hour Call Center at 1800-209-5858 http://twitter.com/BajajAllianz

www.bajajallianz.com http://www.linkedin.com/company/bajaj-allianz-general-insurance
bagichelp@bajajallianz.co.in Demystify Insurance https://www.bajajallianz.com/blog.html

HEALTH ENSURE - INDIVIDUAL- POLICY SCHEDULE
UIN: BAJHLIP23211V052223
Premium Details
Description Amount Description Amount
Base Premium 26697 Long Term Policy Discount 0
Premium Payment Zone Zone B Employee Discount 0
Loading Rate 1334 Loading Amount 1334
Online Discount/Direct
0 Net Premium 48032
Customer Discount
Premium on Add-on Cover 0 State GST(9%) 2523
Premium on Health Prime Rider 0 Central GST(9%) 2523
Discount on Health Prime Rider 0 IGST 0

Premium on Respect Rider 0 UTGST 0
Discount on Respect Rider 0 CESS 0

Gross Premium: Sixty-Three Thousand Seventy-Eight Gross Premium 63078
Rupees
"As per the GST regulations, the amount of GST will not be refunded if the policy / endorsement is cancelled after 30th September of the next
financial year E. & O.E"
"In case no GSTIN or incorrect GSTIN is provided by the Proposer at Proposal stage, Bajaj Allianz General Insurance Company Ltd shall not be
responsible for any Input Tax Credit losses and no subsequent revision of invoice will be undertaken."
“I/We hereby declare that though our aggregate turnover in any preceding financial year from 2017-18 onwards is more than the aggregate turnover
notified under sub-rule (4) of rule 48, we are not required to prepare an invoice in terms of the provisions of the said sub-rule.”
Exclusions
Member Name Exclusion
Sulochana Kamalakar Accept with 5.0 % loading in view of Hypertension , & exclusion as follows : applicable on enhanced sum
Deshmukh insured-It is hereby agreed and understood that this Policy Excludes For SULOCHANA KAMALAKAR DESHMUKH
any claims in respect of any disorder, injury, disease, disability or treatment directly caused by or attributable to
Hypertension,Cardiovascular diseases,Cerebrovascular diseases its complications & related disorders/any other
ailment existing on or before the commencement date. The above exclusion shall cease to apply from 3rd year,
if you have maintained a Health Ensure Policy with us for a continuous period of a full 2 years without break
from the date of your first Health Ensure Policy with Us.
Special Exclusion at Policy Accept. Break in clause: Any medical expenses incurred as a result of disease condition/ Accident
Level contracted during the break period will not be admissible under the policy.
Additional Remarks NA
This is to certify that Yogesh Kamalakar Deshmukh has paid Rs.33078 towards Health Insurance
premium for Period and Policy Number as mentioned on the Policy Schedule and is eligible for
Deduction under Section 80-D of Income Tax (Amendment) Act, 1986
Notes:
80 D Certificate 1 . This is subject to the provisions of Section 80D of income tax (Amendment) Act, 1986 as amended
from time to time.
2. This certificate must be surrendered to the company in case of cancellation of this policy.
3 . In event of incorrect representation of this declaration the liability shall be upon the policy holder.
4. This certificate will not be valid if premium payment has been made in cash.
Receipt Number: SYS-23-000007096365, SYS-23-000007096365 Date: 23/11/2023, 23/11/2023
Premium Payment Details Premium Payer ID: 85368840 Float: NA; Payment Frequency: Single Premium ** If Premium paid through
Cheque, the Policy is void ab-initio in case of dishonour of Cheque
Financial Institution Ref. NA
HEALTH ENSURE - INDIVIDUAL- POLICY SCHEDULE
UIN: BAJHLIP23211V052223
AGENCY CODE 10038252 CONTACT NO 09860097132
AGENCY NAME Seemaraniverma Rani EMAIL ID SATYAMVERMA@HOTMAIL.COM
For & on the behalf

Bajaj Allianz General Insurance Company Ltd. Consolidated Stamp Duty of Rs. 0.25/- paid towards Insurance Stamps vide Challan No.
MH009975032202324M Defaced No. 0005568654202324 Order No.CSD/17/2023/4571
Signature Not Verified Order Dated 10/11/2023 DEFACED DATE dated 10/11/2023 timing 15:32:10 PM of
Digitally signed by DS BAJAJ General Stamp Office, Mumbai, India
Stamp Duty
COMPANY LIMITED 01 Rs.0.25/- This document is digitally signed,hence counter signature / stamp is not required
Date: 2023.11.29 12:36:20
08 IST
Principal Location : Bajaj Allianz House, Airport Road, Yerwada, Pune- 411006 PH-
66026666 | Services Accounting Code : 997133 Accident and health insurance services.
SUB 10038252 / NA
“The amounts present in the document are calculated with INR currency if not mentioned otherwise.”
Policy Verification Claim Registration
Our Insurance Expert will call you for hassle free renewal and industry best offers on your coverage
Bajaj Allianz General Insurance Co.Ltd. Bajaj Allianz House,Airport Road,Yerwada,Pune - 411006. Reg.No.:113 CIN:U66010PN2000PLC015329
Give a Missed Call on 8080945060, SMS 'WORRY' to 575758 http://www.facebook.com/BajajAllianz

RECEIPT
Policy issuing office and Correspondence address for communication AURUNGABAD-Abc East,,3rd Floor,,Chilkathana Midc,,
by policyholder for claim, service request, notice, summons, etc. Aurangabad,Maharashtra,431210,INDIA
Proposer Name Yogesh Kamalakar Deshmukh Policy Number 12-8435-0000079326-00
Receipt Number SYS-23-000007096365, SYS-23- Receipt Date 23/11/2023, 23/11/2023
Business Channel SEEMARANIVERMA RANI(10038252)
Received with thanks from: Mandar Chandrakant Lokhande
Customer ID: 85368840 a total sum of Rupees Thirty-Three Thousand Seventy-Eight Rupees Only by,
Instrument Type Instrument No Instrument Date Bank Name Branch Name Amount (Rs.)
NA NA NA NA NA 0
Total Amount: 33078
Note: Issuance of this receipt does not amount of acceptance of the risk by Bajaj Allianz General Insurance Company Limited. The insurance cover for
the risk shall be as per the terms and conditions of the Insurance Policy if and when issued.
*Cheque/DD/PO receipt is valid subject to realisation of the instrument
For & on the behalf


COMPANY LIMITED 01
Date: 2023.11.29 12:36:20
07 IST
Bajaj Allianz General Insurance Co.Ltd.Bajaj Allianz House,Airport Road,Yerwada,Pune - 411006. Reg.No.:113 CIN:U66010PN2000PLC015329


Transcript of Proposal for ([11-8435-0000676808-00] HEALTH ENSURE -
INDIVIDUAL) [(UIN):BAJHLIP23211V052223]
Dear Yogesh Kamalakar Deshmukh,

We wish to inform you that your contract will be based on the information and declaration given by you through telephonic conversation / email / web-
inputs / TAB /CSC Centers or other means which would be considered as the final proposal, the transcript of which is as follows:
You are requested to yourself reconfirm the same at your end. In case of any disagreement or objection or any changes with respect to information
mentioned below, we request you to please revert within a period of 15 days from the date of your receipt of this document. In case of our non-receipt
of your disagreement or objection or any changes [as mentioned hereinabove] with respect to information mentioned below, it shall be deemed that
you have positively confirmed to us the correctness of the below mentioned transcript and declaration. Where you disagree to any of
information/contents of this transcript, standard Terms or conditions, you have the option to return the original Policy stating the reasons for your
objection, and upon our receipt of original Policy together with your request to cancel the Policy, you shall be entitled to a refund of the premium paid,
subject only to there being no claim made under the Policy and also subject to a deduction of the expenses incurred by us and the stamp duty
charges.
Proposer Details
Proposer Name Mandar Chandrakant Lokhande
Are you an Existing Bajaj Allianz Customer: Yes/No If Yes, please mention the policy No
Gender Male Date of Birth 04/05/1987
PAN No NA
Bajaj Allianz Employee Code, if Proposer is BAGIC/BALIC Employee NA
Marital Status NA No of children NA
Occupation Housewife
Address
Permanent/ Residential Address Correspondence Address
(All the communications will be sent to the below address )
Address Line 1 L2 1011, Near Hamuman N 2 Temple Ramnagar Address Line 1 L2 1011, Near Hamuman N 2 Temple Ramnagar
Address Line 2 NA Address Line 2 NA
Address Line 3 NA Address Line 3 Aurangabad City
City/District AURANGABAD City/District AURANGABAD
State 27 - MAHARASHTRA State MAHARASHTRA
Pin Code 431001 Pin Code 431001
Telephone NA Telephone NA
Mobile 7588177352 Mobile NA
Email yogeshdeshmukh1987@gmail.com Email yogeshdeshmukh1987@gmail.com
Educational Qualification NA
Family Monthly Income 0
In case of any offer, you would prefer to be contacted by 7588177352 / yogeshdeshmukh1987@gmail.com
Nationality Indian
Policy Term 1 Year
Premium Payment Zone to be opted Zone B
There are Three Zones for Premium payment-

Zone A
Delhi/NCR, Mumbai including (Navi Mumbai, Thane and Kalyan), Hyderabad and Secunderabad, Kolkata, Ahmedabad, Vadodara and Surat.
No Co-Payment
Zone B
Rest of India apart from Zone A & Zone C
* 15% Co-Payment Applicable if treatment availed in Zone A locations
Zone C
Goa,Chhattisgarh,Punjab,Chandigarh,Jammu & Kashmir,Jharkhand,Arunachal Pradesh, Bihar, Himachal Pradesh,Nagaland, Odisha,
Sikkim,
Tripura,
*20% & Uttarakhand,
5% Co-Payment Manipur, Meghalaya,Mizoram,Andaman
Applicable & Nicobar
if treatment availed in Zone A andislands
Zone B locations respectively
Kindly note that as the information/contents and declarations/confirmations provided by you as contained in this transcript is the basis on which we are
issuing / have issued the Policy to you, we advise you to please ensure that you have provided/disclosed and or not withheld any material
facts/information and declarations, as Policy becomes Void ab-initio if material facts are not provided/disclosed and or withheld and in such case no
claim, if any, will be considered by us apart from forfeiture of the premium.
Disclaimer
A. EXCLUSIONS AND TERMS AND CONDITIONS:
The detailed list of exclusions, standard terms and conditions, including the exclusion of pre-existing ailments/diseases, were fully explained to you and
for full details thereof please refer to the Policy wordings:
Answer given by You: Yes, I/we have been explained in full the details of exclusions, standard terms and conditions including the exclusion of pre-
existing ailments/diseases and knowing the same I/we have opted and proposed for this Policy.
B. The contents of the proposal [transcript of proposal of you is this document] and connected documents have been fully explained to him and you
have fully understood the significance of the proposed contract basis which you have confirmed for policy issuance.
C. In case of Disagreement or objection or any changes with respect to information, declarations, Terms and Conditions, exclusions and contents
mentioned hereinabove, please contact our toll free number & register your objections / changes / disagreement to the contents of this transcript or you
may also send us email or written correspondence at the following details within a period of 15 days from date of your receipt of this transcript along
with Policy.
Declaration
1. I hereby declare, on my behalf and on behalf of all persons proposed to be insured, that the above statements, answers and/or particulars given by
me are true and complete in all respects to the best of my knowledge and that I am authorised to propose on behalf of these other persons.
2. I understand that the information provided by me will form the basis of the insurance policy, is subject to the Board approved underwriting policy of
the insurer and that the policy will come into force only after full payment of the premium chargeable.
3. I further declare that I will notify in writing any change occurring in the occupation or general health of the life to be insured/proposer after the
proposal has been submitted but before communication of the risk acceptance by the company.
4. I declare that I consent to the company seeking medical information from any doctor or hospital who/which at any time has attended on the person
to be insured/proposer or from any past or present employer concerning anything which affects the physical or mental health of the person to be
insured/proposer and seeking information from any insurer to whom an application for insurance on the person to be insured /proposer has been made
for the purpose of underwriting the proposal and/or claim settlement.
5. I authorize the company to share information pertaining to my proposal including the medical records of the insured/proposer for the sole purpose of
underwriting the proposal and/or claims settlement and with any Governmental and/or Regulatory authority.
Prohibition of Rebates
SECTION 41 OF INSURANCE ACT, 1938
No person shall allow or offer to allow, either directly or indirectly, as an inducement to any person to take out or renew or continue an insurance in
respect of any kind of risk relating to lives or property in India, any rebate of the whole or part of the commission payable or any rebate of the premium
shown on the policy, nor shall any person taking out or renewing or continuing a policy accept any rebate except such rebate as may be allowed in
accordance with the published prospectuses or tables of the Insurer. Any person making default in complying with the provisions of this section shall
be punishable with a penalty, which may extend to Ten Lakh Rupees.
Contact our Policy servicing branch at: AURUNGABAD-Abc East,,3rd Floor,,Chilkathana Midc,,Aurangabad,Maharashtra,INDIA,431210
** This is print of electronic records maintained by us in accordance with law and hence does not require signature.
Bajaj Allianz General Insurance Co.Ltd. Bajaj Allianz House,Airport Road,Yerwada,Pune - 411006. Reg.No.:113 CIN:U66010PN2000PLC015329
Give a Missed Call on 8080945060,SMS to 575758 http://www.facebook.com/BajajAllianz
"WORRY"
Contact our 24-Hour Call Center at1800-209-5858
http://twitter.com/BajajAllianz
www.bajajallianz.com
http://www.linkedin.com/company/bajaj-allianz-general-insurance
bagichelp@bajajallianz.co.in
Demystify Insurance https://www.bajajallianz.com/blog.html
Bajaj Allianz General Insurance Co.Ltd.
Give a Missed Call on 8080945060,SMS 'WORRY' to
Contact our 24-Hour Call Center at1800-209-5858
www.bajajallianz.com bagichelp@bajajallianz.co.in
HEALTH & WELLNESS CARD
Policy issuing office and Correspondence address for communication AURUNGABAD-Abc East,,3rd Floor,,Chilkathana Midc,,Aurangabad,
by policyholder for claim, service request, notice, summons, etc. Maharashtra,431210,INDIA
Proposer Name Yogesh Kamalakar Deshmukh Policy Number 12-8435-0000079326-00
Health Card Number: 31-8435-0015339982-0001

Customer ID: 86609246
Policy No: 12-8435-0000079326-00
Inception Date: 23/11/2023
Valid Up to: 22/11/2024
Member Name: Sulochana Kamalakar Deshmukh
Age: 66
HEALTH & WELLNESS CARD
Bajaj Allianz General Insurance Company

(A Company incorporated under Indian Companies Act, 1956 and licensed by Insurance
Regulatory and Development Authority of India [IRDAI] vide Reg No. 113)
Regd.Office: Bajaj Allianz House, Airport Road, Yerwada, Pune-411006 (India)
Cashless hospitalization in network hospitals can be obtained only if this card is produced along
with a letter of authorization from Bajaj Allianz except for emergency cases. This is subject to
terms and conditions of the policy. Please quote your ID number for assistance. Intimation to
Bajaj Allianz Helpline is mandatory in case of any hospitalization.
HOSPITAL ALERT: In emergency, Patient may approach with id card; please call Bajaj Allianz
helpline to verify coverage and cashless authorization.
For help and more information:

Say Hi on WhatsApp on 7507245858, Give a Missed Call on 8080945060, SMS ‘WORRY’ to
575758, Contact our 24-Hour Call Center at 1800-209-5858
Email: Bagichelp@bajajallianz.co.in, Website www.bajajallianz.com
Corporate Identification Number: U66010PN2000PLC015329
Bajaj Allianz House,Airport Road,Yerwada,Pune - 411006. Reg.No.: 113 CIN: U66010PN2000PLC015329

Bajaj Allianz General Insurance Co.Ltd. http://www.facebook.com/BajajAllianz
Give a Missed Call on 8080945060,SMS 'WORRY' to 575758 http://twitter.com/BajajAllianz
Contact our 24-Hour Call Center at1800-209-5858 http://www.linkedin.com/company/bajaj-allianz-general-insurance
www.bajajallianz.com bagichelp@bajajallianz.co.in
Demystify Insurance https://www.bajajallianz.com/blog.html
Certificate for the purpose of deduction under Section 80-D of Income Tax
Amendment Act, 1986
This is to certify that Yogesh Kamalakar Deshmukh has paid Rs. 33078 towards Health Insurance premium for
HEALTH ENSURE - INDIVIDUAL for the period from 23/11/2023 to midnight of 22/11/2024 under Policy no 12-8435-
0000079326-00
FINANCIAL YEAR AMOUNT
2023-2024 33078.00
Issue Date: 29/11/2023

Place: AURUNGABAD-Abc East,,3rd Floor,,Chilkathana Midc,,
For & on the behalf of

COMPANY LIMITED 01
Date: 2023.11.29 12:36:20
1 IST
This certificate must be surrendered to the company for issuance of fresh certificate in case of cancellation of the Policy or any alteration
in the insurance affecting premium.
Notes:
1. This is subject to the provisions of Section 80D of income tax (Amendment) Act, 1986 as amended from time to time.
2. This certificate must be surrendered to the company in case of cancellation of this policy.
3. In event of incorrect representation of this declaration the liability shall be upon the policy holder.
4. This certificate will not be valid if premium payment has been made in cash.
“The amounts present in the document are calculated with INR currency if not mentioned otherwise.”
Policy Verification Claim Registration
Bajaj Allianz House,Airport Road,Yerwada,Pune - 411006. Reg.No.:113 CIN:U66010PN2000PLC015329

Bajaj Allianz General Insurance Co.Ltd. http://www.facebook.com/BajajAllianz
Give a Missed Call on 8080945060,SMS 'WORRY' to 575758 http://twitter.com/BajajAllianz

Contact our 24-Hour Call Center at1800-209-5858 http://www.linkedin.com/company/bajaj-allianz-general-insurance
www.bajajallianz.com bagichelp@bajajallianz.co.in Demystify Insurance https://www.bajajallianz.com/blog.html

TAX INVOICE
(Customer Copy)
Invoice Number 272311I001868969 Customer ID 85368840
Invoice Date 29/11/2023 Policy No. 12-8435-0000079326-00
Recipient/ Details of Insured Supplier/ Details of Insurer
GSTIN Unregistered GSTIN 27AABCB5730G1ZX
PAN NA PAN AABCB5730G
Name (Proposer) Yogesh Kamalakar Deshmukh Name Bajaj Allianz General Insurance Company Ltd.
Address-1 L2 1011, Near Hamuman N 2 Temple Ramnagar Address-1 Abc East,
Address-2 NA Address-2 3rd Floor,
Address-3 NA Address-3 Chilkathana Midc,
Pin Code 431001 Pin Code 431210
City AURANGABAD City AURANGABAD
State MAHARASHTRA State MAHARASHTRA
Client Category NON HNI Place of Supply 27 - MAHARASHTRA
Premium Details
Description Amount Description Amount
Net Premium 28032 State GST(9%) 2523

Receipt Number: SYS-23-000007096365, SYS-23-
Central GST(9%) 2523
000007096365 Date: 23/11/2023, 23/11/2023 Premium Payer ID:
85368840 Float: NA; ** If Premium paid through Cheque, the 0
IGST(18%)
Policy is void ab-initio in case of dishonour of Cheque
UTGST(9%) 0
CESS 0
Gross Premium 33078
Total Invoice Value (In Words) : Thirty-Three Thousand Seventy-Eight Rupees

Amount of Tax Subject to Reverse Charge: No reverse charge is payable on these services.
Services Accounting Code: 997133 Accident and health insurance services.
Principal Location: Bajaj Allianz House, Airport Road, Yerwada, Pune- 411006 PH-66026666
For & on the behalf

COMPANY LIMITED 01
Date: 2023.11.29 12:36:20
07 IST
Important Notes:
* The invoice is issued as per Section 31 of the CGST Act
* In case no GSTIN or incorrect GSTIN is provided by the Proposer at Proposal stage, Bajaj Allianz General Insurance Company Ltd shall not be responsible for
any Input Tax Credit losses and no subsequent revision of invoice will be undertaken
* As per the GST regulations, the amount of GST will not be refunded if the policy / endorsement is cancelled after 30th September of the next financial year E.
& O.E
“I/We hereby declare that though our aggregate turnover in any preceding financial year from 2017-18 onwards is more than the aggregate turnover notified
under sub-rule (4) of rule 48, we are not required to prepare an invoice in terms of the provisions of the said sub-rule.”
This is a digitally signed document and hence no physical signature is required
Bajaj Allianz General Insurance Co. Bajaj Allianz House,Airport Road,Yerwada,Pune - 411006. Reg.No.:113 CIN:U66010PN2000PLC015329

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Welcome to Bajaj Allianz Family

Insured Name Yogesh Kamalakar Deshmukh Policy number 12-8435-0000079326-00

Name: Mandar Chandrakant Lokhande

Dear Mandar Chandrakant Lokhande,

For & on the behalf

Signature Not Verified

Give a Missed Call on 808094506 SMS 'WORRY' to 575758 http://www.facebook.com/BajajAllianz

Contact our 24-Hour Call Center at 1800-209-5858 http://twitter.com/BajajAllianz

bagichelp@bajajallianz.co.in Demystify Insurance https://www.bajajallianz.com/blog.html

Base Premium 26697 Long Term Policy Discount 0

Premium Payment Zone Zone B Employee Discount 0

Loading Rate 1334 Loading Amount 1334

Premium on Add-on Cover 0 State GST(9%) 2523

Premium on Health Prime Rider 0 Central GST(9%) 2523

Discount on Health Prime Rider 0 IGST 0

Discount on Respect Rider 0 CESS 0

For & on the behalf

Policy Verification Claim Registration

Contact our 24-Hour Call Center at 1800-209-5858 http://twitter.com/BajajAllianz

Proposer Name Yogesh Kamalakar Deshmukh Policy Number 12-8435-0000079326-00

Receipt Number SYS-23-000007096365, SYS-23- Receipt Date 23/11/2023, 23/11/2023

Business Channel SEEMARANIVERMA RANI(10038252)

Received with thanks from: Mandar Chandrakant Lokhande

Total Amount: 33078

For & on the behalf

Signature Not Verified

Contact our 24-Hour Call Center at 1800-209-5858 http://twitter.com/BajajAllianz

bagichelp@bajajallianz.co.in Demystify Insurance https://www.bajajallianz.com/blog.html

Dear Yogesh Kamalakar Deshmukh,

Gender Male Date of Birth 04/05/1987

Bajaj Allianz Employee Code, if Proposer is BAGIC/BALIC Employee NA

Marital Status NA No of children NA

Address Line 2 NA Address Line 2 NA

Address Line 3 NA Address Line 3 Aurangabad City

City/District AURANGABAD City/District AURANGABAD

State 27 - MAHARASHTRA State MAHARASHTRA

Pin Code 431001 Pin Code 431001

Mobile 7588177352 Mobile NA

Email yogeshdeshmukh1987@gmail.com Email yogeshdeshmukh1987@gmail.com

Family Monthly Income 0

In case of any offer, you would prefer to be contacted by 7588177352 / yogeshdeshmukh1987@gmail.com

Policy Term 1 Year

Premium Payment Zone to be opted Zone B

There are Three Zones for Premium payment-

A. EXCLUSIONS AND TERMS AND CONDITIONS:

Give a Missed Call on 8080945060,SMS 'WORRY' to

Contact our 24-Hour Call Center at1800-209-5858

Proposer Name Yogesh Kamalakar Deshmukh Policy Number 12-8435-0000079326-00

Health Card Number: 31-8435-0015339982-0001

HEALTH & WELLNESS CARD

Bajaj Allianz General Insurance Company

Regd.Office: Bajaj Allianz House, Airport Road, Yerwada, Pune-411006 (India)

For help and more information:

Bajaj Allianz House,Airport Road,Yerwada,Pune - 411006. Reg.No.: 113 CIN: U66010PN2000PLC015329

Give a Missed Call on 8080945060,SMS 'WORRY' to 575758 http://twitter.com/BajajAllianz

Contact our 24-Hour Call Center at1800-209-5858 http://www.linkedin.com/company/bajaj-allianz-general-insurance

FINANCIAL YEAR AMOUNT

Issue Date: 29/11/2023

For & on the behalf of

Policy Verification Claim Registration

Bajaj Allianz House,Airport Road,Yerwada,Pune - 411006. Reg.No.:113 CIN:U66010PN2000PLC015329

Give a Missed Call on 8080945060,SMS 'WORRY' to 575758 http://twitter.com/BajajAllianz